Bhutan eliminated measles but imported cases are a challenge

Bhutan achieved the measles elimination status in April last year, being one of the first two countries to eliminate measles in WHO South-East Asian region (SEAR) before the 2020 regional target.

A series of vaccination and awareness campaign were carried out since 1979 to achieve the goal. The health ministry also carried out nationwide measles and rubella catch up immunization campaign last year, in all the schools and high-risk areas, which includes near the border and pockets of low immunization coverage.

Following zero case of measles in 2013 and 2014, the sporadic cases of small measles outbreaks were experienced in 2015, 2016 and 2017. Laboratory officer of the Royal Centre of Disease Control, Jit Bdr. said the cases reported are due to the disease surveillance and availability of facilities in every hospital to diagnose the disease.

Meanwhile, out of 21 suspected cases of measles in the first two months of 2018, 7 are confirmed cases. After the investigation was done, based on genotype of measles, it is confirmed that all the cases are the imported strain of the disease. Jit Bdr. Said that most of the suspected cases were from the border areas.

“Even the cases that were reported in Thimphu were confirmed to be imported ones.” He added that most of the cases which were reported so far, since the past years, were found to be imported ones.

However, Bhutan has not seen any case of indigenous measles since 2012. The definition of elimination of measles stands for zero indigenous cases in a country.

Deputy Chief Programme officer of the vaccine preventable disease program, Tshewang Tamang, said that although the elimination target has been achieved, few sporadic cases are expected.

The case is expected mainly from isolated pockets of susceptible populations in geographically difficult terrains and migrant populations in border areas.

Tshewang Tamang said the main source of transmission of disease is from the countries that have not reached the elimination process and due to trans-boundary infections. “This is why we have mainly targeted the areas near the border and covering the areas with mass population, like schools and colleges which are at higher risks.” He said that this is the only way to prevent the disease as of now.

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